COVID-19 en el enfermo renal. Revisión breve / COVID-19 in renal patient. Brief Review

En diciembre de 2019 se identificó en China una nueva subespecie de coronavirus al que denominaron SARS-CoV-2, responsable de la enfermedad posterior a la que la OMS llamó COVID-19. La enfermedad se ha propagado rápidamente provocando una pandemia mundial. Todavía se desconoce mucho del SARS-CoV-2, pero las primeras investigaciones respaldan la hipótesis de que la gravedad de la COVID-19 viene condicionada por la respuesta hiperinflamatoria que se produce en nuestro organismo al contacto con el SARS-CoV-2. La gravedad del cuadro se relaciona con la insuficiencia respiratoria que provoca, no obstante, existen estudios que no limitan la afectación pulmonar. Investigaciones apuntan a que el mecanismo de acceso del SARS-CoV-2 al organismo está muy relacionado con la enzima ACE2. Enzima que entre otros tejidos, se puede encontrar en el epitelio de las células tubulares renales. Esta es la causa por la que existen datos de pacientes con COVID-19 que tienen una gran afectación en la función renal y pueden cursar con IRA (factor de mal pronóstico). Por este motivo, unido a que las comorbilidades asociadas con una mayor mortalidad durante la infección COVID-19 son comunes en los pacientes con enfermedad renal crónica, creemos necesario conocer los resultados que aportan los diferentes estudios realizados sobre esa materia

In December 2019, a new subspecies of coronavirus was identified in China, which was named SARS-CoV-2, responsible for the disease that WHO called COVID-19. The disease has spread rapidly causing a global pandemic. Much is still unknown about SARS-CoV-2, but the first findings support the hypothesis that the severity of COVID-19 is conditioned by the hyperinflammatory response, which occurs in our body after contacting SARS-CoV-2. The severity of the symptoms is conditioned by the respiratory failure caused, however there are studies that are not limited to lung involvement. Evidence suggests that the access mechanism of the SARS-CoV-2 virus is closely related to the ACE2 enzyme. An enzyme that, among other tissues, can be found in the epithelium of renal tubular cells. For this reason, there are data on patients with COVID-19 who are severely affected in kidney function and may have acute kidney failure (a poor prognostic factor). For this reason, together with the fact that the comorbidities associated with a higher mortality during COVID-19 infection are common in patients with chronic kidney disease, it is necessary to know the available evidence on this matter

Alteraciones de la nutrición en la enfermedad renal / Nutrition disorder in renal disease

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What is the perception of biological risk by undergraduate nursing students?

OBJECTIVE: to analyze undergraduate nursing students' perception of biological risk and its relationship with their prior practical training. METHOD: a descriptive cross-sectional study was conducted among undergraduate nursing students enrolled in clinical practice courses in the academic year 2013-2014 at the School of Nursing at the University of Barcelona. VARIABLES: sociodemographic variables, employment, training, clinical experience and other variables related to the assessment of perceived biological risk were collected. Both a newly developed tool and the Dimensional Assessment of Risk Perception at the worker level scale (Escala de Evaluación Dimensional del Riesgo Percibido por el Trabajador, EDRP-T) were used. STATISTICAL ANALYSIS: descriptive and univariate analysis were used to identify differences between the perception of biological risk of the EDRP-T scale items and sociodemographic variables. RESULTS: students without prior practical training had weaker perceptions of biological risk compared to students with prior practical training (p=0.05 and p=0.04, respectively). Weaker perceptions of biological risk were found among students with prior work experience. CONCLUSION: practical training and work experience influence the perception of biological risk among nursing students.

Simulación clínica en enfermería comunitaria / Clinical simulation in nursing community

Introducción: La finalidad de esta investigación fue evaluar los resultados de aprendizaje del alumno en relación con las competencias en enfermería comunitaria y valorar la satisfacción de éstos respecto a la simulación clínica en este contexto. Material y métodos: Estudio descriptivo observacional realizado en el primer semestre del curso 2014/2015 en el Campus Docent Sant Joan de Déu. Se hizo un análisis cualitativo de la conducción de 30 debriefings donde se evaluaron los resultados de aprendizaje en relación con los siguientes ítems (aspectos emocionales, toma de decisiones, valoración integral del paciente, valoración del paciente en atención domiciliaria, comunicación, educación sanitaria y habilidades técnicas). La satisfacción de los estudiantes se evaluó mediante un cuestionario compuesto por ocho ítems valorados mediante una escala ordinal (contenidos, coordinación, tiempo, metodología, utilidad, material, conocimientos y expectativas) y se realizó un análisis descriptivo de cada uno de ellos. Resultados: El análisis de los debriefings mostró que los alumnos tienen dificultades para realizar la valoración del paciente con los instrumentos que se utilizan en la práctica clínica; sin embargo, presentan buenas habilidades comunicativas con el usuario y la familia. Respecto al grado de satisfacción, participaron en la cumplimentación del cuestionario 47 estudiantes de tercer curso de grado y la puntuación media total de los alumnos fue de 9,08 ± 0,85. La utilidad del taller fue valorada con una media superior a 9. Conclusiones: La simulación clínica es una metodología docente valorada satisfactoriamente por parte de los alumnos que permite trabajar objetivos relacionados con habilidades técnicas y con habilidades no técnicas

Introduction: The purpose of this research was to evaluate the learning outcomes of students in relation to competencies in community nursing and rating the satisfaction regarding the clinical simulation in this context. Material and methods: Descriptive observational study conducted in the first semester of the academic year 2014 / 2015 on the Campus Docent Sant Joan de Déu. A qualitative analysis of driving 30 debriefings where assessed learning outcomes in relation to the following items (emotions, decision-making, comprehensive patient assessment, assessing the patient in home care, communication, health education and technical skills) was made. Student satisfaction was assessed using a questionnaire consisting of 8 items valued using an ordinal scale (content, coordination, time, methodology, tool, material, knowledge, expectations) and we performed a descriptive of each analysis. Results: The analysis of the debriefings showed that students have difficulties to conduct the assessment of the patient with the instruments that are used in clinical practice, however have good communicative skills with the user and the family. Regarding the degree of satisfaction, participated in filling in the questionnaire, 47 students in third year of degree, the total average score of students was 9.08 ± 0.85. The usefulness of the workshop was appraised with a superior half to 9. Conclusions: Clinical simulation is a valued teaching methodology successfully by students, which allows work related technical skills and abilities not technical objectives

El ejercicio físico y el paciente renal crónico / No disponible

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La insuficiencia hepática aguda grave: estudio de un caso / Severe acute liver failure: a case study

La insuficiencia hepática aguda grave (IHAG), también conocida como hepatitis fulminante, presenta un cuadro clínico poco frecuente y extraordinariamente grave ya que cursa con una elevada mortalidad. Su rápida evolución y la complejidad en el manejo del tratamiento, crea la necesidad de prestar unos cuidados inmediatos por parte de un equipo especializado en cuidados intensivos. Esta descompensación aguda normalmente va asociada a otras alteraciones como la coagulopatía y la encefalopatía hepática, siendo responsable de importantes complicaciones que pueden derivar en fallo multiorgánico. En nuestro medio la etiología más frecuente es la desconocida, seguida de la infección aguda por el virus de la hepatitis B. El tratamiento de este síndrome se basa en las medidas generales aplicables a cualquier paciente crítico: tratar la causa y detectar precozmente las complicaciones extrahepáticas, siendo el trasplante hepático urgente una de las alternativas con mejor pronóstico.En este artículo se presenta un caso clínico en el que se describe el seguimiento de una mujer irlandesa de 20años que es derivada desde un hospital de Ibiza a un hospital de Barcelona, por sospecha diagnóstica de IHAG. Siguiendo el modelo conceptual de Virginia Henderson, se han descrito los problemas de colaboración y los diagnósticos de enfermería, presentando el plan de cuidados según la taxonomía North American Nursing Association (NANDA), Nursing Intervention Classification (NIC), Nursing Outcomes Classification (NOC). Este caso ayuda a establecer un plan de cuidados individualizado en el que orienta a los profesionales enfermeros en el cuidado del paciente crítico reforzando los conocimientos relacionados con la IHAG (AU)

Fulminant hepatic failure (FHF), also known as fulminant hepatitis, is a rare and extremely serious condition with a high mortality rate. Its rapid evolution and complexity in managing the treatment, creates the need to provide some immediate care by a team that specialises in intensive care. This acute decompensation is usually associated with other disorders, such as coagulopathy and hepatic encephalopathy, being responsible for major complications that can lead to organ failure. In our region the most common origin is unknown, followed by acute infection with hepatitis B. The treatment of this syndrome is based on the general measures applicable to any critically ill patient: treat the cause and early detection of extrahepatic complications, urgent liver transplantation being one of the alternatives with a better prognosis.This article presents a case report describing the monitoring of an Irish woman of 20years who was transferred from a hospital in Ibiza to a hospital in Barcelona, with a suspected diagnosis of FHF. Following the conceptual model of Virginia Henderson, the collaborative problems and nursing diagnoses are described, presenting a care plan according to NANDA (North American Nursing Association), NIC (Nursing Intervention Classification), NOC (Nursing Outcomes Classification). This case helps to establish an individualised care plan that provides guidance to nurse professionals in critical patient care by increasing the knowledge of FHF (AU)

[Severe acute liver failure: a case study]. / La insuficiencia hepática aguda grave: estudio de un caso.

Fulminant hepatic failure (FHF), also known as fulminant hepatitis, is a rare and extremely serious condition with a high mortality rate. Its rapid evolution and complexity in managing the treatment, creates the need to provide some immediate care by a team that specialises in intensive care. This acute decompensation is usually associated with other disorders, such as coagulopathy and hepatic encephalopathy, being responsible for major complications that can lead to organ failure. In our region the most common origin is unknown, followed by acute infection with hepatitis B. The treatment of this syndrome is based on the general measures applicable to any critically ill patient: treat the cause and early detection of extrahepatic complications, urgent liver transplantation being one of the alternatives with a better prognosis. This article presents a case report describing the monitoring of an Irish woman of 20 years who was transferred from a hospital in Ibiza to a hospital in Barcelona, with a suspected diagnosis of FHF. Following the conceptual model of Virginia Henderson, the collaborative problems and nursing diagnoses are described, presenting a care plan according to NANDA (North American Nursing Association), NIC (Nursing Intervention Classification), NOC (Nursing Outcomes Classification). This case helps to establish an individualised care plan that provides guidance to nurse professionals in critical patient care by increasing the knowledge of FHF.

Estudiantes de enfermería. Prevención de riesgos biológicos / Updated review on the prevention of biological hazards in the nursing students

Si la realización de las prácticas es algo importante en todas las titulaciones, en Enfermería resulta fundamental y tiene un gran impacto educativo. Durante este período los alumnos, además de poner en práctica los conocimientos teóricos, toman contacto con la realidad, donde se exponen a una serie de peligros inherentes a dicha profesión. A este hecho hay que añadir varios factores que agravan la situación: la inexperiencia como profesionales, la aparición de cierto grado de estrés provocado por las situaciones variables y de incertidumbre que los rodean, y la no contemplación de este colectivo por parte de la Ley de Prevención de Riesgos Laborales. Todo ello hace al alumnado más vulnerable frente a los riesgos(AU)

If the carrying out a practices is something extremely important in all degree studies, in the case of nursing this is something even more fundamental and of great educational impact. During that period, students not only put their knowledge and theory into practice, they get in touch with reality and they also expose themselves to a series of risks inherent to our profession. In addition to that, one has to take into account the appearance of various factors that aggravate their susceptibility; their inexperience as professionals, their exposure to some degree of stress due to the variable conditions and uncertainties in their environment, the lack of coverage under the PRL law, makes this group more vulnerable to the risks(AU)

[Updated review on the prevention of biological hazards in the nursing students]. / Estudiantes de enfermería. Prevención de riesgos biológicos.

If the carrying out a practices is something extremely important in all degree studies, in the case of nursing this is something even more fundamental and of great educational impact. During that period, students not only put their knowledge and theory into practice, they get in touch with reality and they also expose themselves to a series of risks inherent to our profession. In addition to that, one has to take into account the appearance of various factors that aggravate their susceptibility, their inexperience as professionals, their exposure to some degree of stress due to the variable conditions and uncertainties in their environment, the lack of coverage under the PRL law makes this group more vulnerable to the risks.